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Tuberculosis (TB) is caused by a bacterium called Mycobacterium tuberculosis. The bacteria usually attack the lungs, but TB bacteria can attack any part of the body such as the kidney, spine, and brain. Not everyone infected with TB bacteria becomes sick. According to the CDC.
The 24 March is World Tuberculosis day. In Rwanda, as for the year 2019-2020, total TB cases all forms detected were 5,678 and among them 930 (16.4%) were brought by CHWs; TB among Children under 15 years remains at 6%; while TB cases were notified among the high-risk groups (PLHIV, Prisoners, TB contacts, children under 15 years and people aged of 55 years. According to the Rwanda Biomedical Center (RBC) 2020 survey.
According to the World Health organisation (WHO), a total of 1.6 million people died from TB in 2021 (including 187 000 people with HIV). Worldwide, TB is the 13th leading cause of death and the second leading infectious killer after COVID-19 (above HIV/AIDS).
In 2021, an estimated 10.6 million people fell ill with tuberculosis (TB) worldwide. Six million men, 3.4 million women and 1.2 million children. TB is present in all countries and age groups. But TB is curable and preventable.
In 2021, 1.2 million children fell ill with TB globally. Child and adolescent TB is often overlooked by health providers and can be difficult to diagnose and treat.
In 2021, the 30 high TB burden countries accounted for 87% of new TB cases
Multidrug-resistant TB (MDR-TB) remains a public health crisis and a health security threat. Only about one in three people with drug resistant TB accessed treatment in 2020.
Globally, TB incidence is falling at about 2% per year and between 2015 and 2020 the cumulative reduction was 11%. This was over half way to the End TB Strategy milestone of 20% reduction between 2015 and 2020.
An estimated 66 million lives were saved through TB diagnosis and treatment between 2000 and 2020.
Globally, close to one in two TB-affected households face costs higher than 20% of their household income, according to latest national TB patient cost survey data. The world did not reach the milestone of 0% TB patients and their households facing catastrophic costs as a result of TB disease by 2020.
By 2022, US$ 13 billion is needed annually for TB prevention, diagnosis, treatment and care to achieve the global target agreed at the UN high level-meeting on TB in 2018.
Funding in low- and middle-income countries (LMICs) that account for 98% of reported TB cases falls far short of what is needed. Spending in 2020 amounted to US$ 5.3 billion less than half (41%) of the global target.
There was an 8.7% decline in spending between 2019 and 2020 (from US$ 5.8 billion to US$ 5.3 billion), with TB funding in 2020 back to the level of 2016.
Ending the TB epidemic by 2030 is among the health targets of the United Nations Sustainable Development Goals (SDGs).
Tuberculosis Types
A TB infection doesn’t always mean you’ll get sick. There are two forms of the disease:
Latent TB. You have the germs in your body, but your immune system keeps them from spreading. You don’t have any symptoms, and you’re not contagious. But the infection is still alive and can one day become active. If you’re at high risk for re-activation — for instance, if you have HIV, you had an infection in the past 2 years, your chest X-ray is unusual, or your immune system is weakened — your doctor will give you medications to prevent active TB.
Active TB. The germs multiply and make you sick. You can spread the disease to others. Ninety percent of active cases in adults come from a latent TB infection.
A latent or active TB infection can also be drug-resistant, meaning certain medications don’t work against the bacteria.
Tuberculosis Signs and Symptoms
Latent TB doesn’t have symptoms. A skin or blood test can tell if you have it.
Signs of active TB disease include:
A cough that lasts more than 3 weeks, Chest pain, Coughing up blood, Feeling tired all the time, Night sweats, Chills, Fever, Loss of appetite, Weight loss.
If you have any of these symptoms, see your doctor to get tested. Get medical help right away if you have chest pain.
Tuberculosis Causes
Tuberculosis is caused by bacteria that spread through the air, just like a cold or the flu. You can get TB only if you come into contact with people who have it.
Tuberculosis Risk Factors
You could be more likely to get TB if:
A friend, co-worker, or family member has active TB.
You live in or have traveled to an area where TB is common, like Russia, Africa, Eastern Europe, Asia, Latin America, and the Caribbean.
You’re part of a group in which TB is more likely to spread, or you work or live with someone who is. This includes homeless people, people who have HIV, people in jail or prison, and people who inject drugs into their veins.
You work or live in a hospital or nursing home.
You’re a health care worker for patients at high risk of TB.
You’re a smoker.
A healthy immune system fights the TB bacteria. But you might not be able to fend off active TB disease if you have:
HIV or AIDS, Diabetes, Severe kidney disease, Head and neck cancers, Cancer treatments such as chemotherapy, Low body weight and poor nutrition, Medications for organ transplants, Certain drugs to treat rheumatoid arthritis, Crohn’s disease, and psoriasis, Babies and young children also have higher chances of getting it because their immune systems aren’t fully formed.
Tuberculosis Transmission
When someone who has TB coughs, sneezes, talks, laughs, or sings, they release tiny droplets that contain the germs. If you breathe in these germs, you can get it.
TB isn’t easy to catch. You usually have to spend a long time around someone who has a lot of the bacteria in their lungs. You’re most likely to catch it from co-workers, friends, and family members.
Tuberculosis germs don’t thrive on surfaces. You can’t get it from shaking hands with someone who has it or by sharing their food or drink.
Tuberculosis Treatment
Your treatment will depend on your infection.
If you have latent TB, your doctor will give you medication to kill the bacteria so the infection doesn’t become active. You might get isoniazid, rifapentine, or rifampin, either alone or combined. You’ll have to take the drugs for up to 9 months. If you see any signs of active TB, call your doctor right away.
A combination of medicines also treats active TB. The most common are ethambutol, isoniazid, pyrazinamide, and rifampin. You’ll take them for 6 to 12 months.
If you have drug-resistant TB, your doctor might give you one or more different medicines. You may have to take them for much longer, up to 30 months, and they can cause more side effects.
Whatever kind of infection you have, it’s important to finish taking all of your medications, even when you feel better. If you quit too soon, the bacteria can become resistant to the drugs.
Tuberculosis Prevention
To help stop the spread of TB:
If you have a latent infection, take all of your medication so it doesn’t become active and contagious.
If you have active TB, limit your contact with other people. Cover your mouth when you laugh, sneeze, or cough. Wear a surgical mask when you’re around other people during the first weeks of treatment.
If you’re traveling to a place where TB is common, avoid spending a lot of time in crowded places with sick people.
